Brief Solution-Oriented Therapy for Couples
Best Practices from Bill O'Hanlon
Recently I attended a brief, solution-oriented therapy for couples' workshop by Bill O'Hanlon. On his handout he said we could spread his ideas as long as we kept his name and contact information on them so here is his contact information: Bill O'Hanlon, M.S., Possibilities, 223 N. Guadalupe #278, Santa Fe, NM 87501, 505-983-2843; Fax # 505-983-2761; PossiBill@aol.com; http://www.billohanlon.com.
In the last few years I have tried to combine brief, solution-oriented therapy, with Rogerian empathetic listening, Virginia Satir's family systems therapy and Martin Seligman's Positive Psychology. All focus on the positive, the solutions rather than the causes of the problem, strengths rather than weaknesses, listening rather than confrontation and the importance of relationships. O'Hanlon fit well with my views.
O'Hanlon's acknowledges and validates clients, yet opens up the possibility for them to change. He says, "Too much emphasis on change and possibility can give clients the message that the therapist does not understand or care about their suffering or dilemmas. Too much emphasis on acknowledgement (Rogers emphasis) can give the message that the client cannot change or might encourage wallowing in pain and hopelessness. He calls his work, "Carl Rogers with a Twist"—introducing possibilities as clients report their problems. Below are the ways he does this with his examples:
1. Reflect back clients' problem reports in the past tense.
Client: I'm depressed.
Therapist: So you've been depressed.
2. When clients give generalities about their problems, introduce the possibility that the problem is not so general. Reflect clients' problems with qualifiers, usually of time (e.g., recently, in the last little while, in the past month or so, most of the time), intensity (e.g., a bit less, somewhat more) or partiality (e.g., a lot, some, most, many)
Client: I've been really depressed.
Therapist: You've been depressed most of the time lately.
3. Translate clients' statements of the truth into statements of clients' perceptions or subjective realities.
Client: From the things she has said and done, it is obvious she doesn't care for our marriage or me.
Therapist: Some of the things she's done have given you the sense she doesn't care.
4. Recast a problem statement into a statement about the preferred future or goal.
Client: I think I'm just too shy to find a relationship. I'm afraid of women and being rejected.
Therapist: So you'd like to be able to get into a relationship?
5. Use present or future tenses to reflect reports of past helpful attention, action and viewpoints.
Client: I stopped myself from bingeing by calling a friend. (Past tense)
Therapist: So one of the things you do to stop bingeing is to call a friend. (Present tense)
6. Presuppose positive changes and progress toward goals by using words like "yet, so far, when and will."
Client: I broke up with my girlfriend and can't seem to find another relationship.
Therapist: So you haven't gotten into a relationship yet. When you get into a relationship, we'll know we've done something useful here.
There was so much more in Bill O'Hanlon's presentation, but these were some of his first key points—that focus on solutions, hope and the positive—reframing even as he reflected the clients concerns. These kinds of methods have worked wonders with some of my clients. Hope you find them helpful too.
April Anderson
SDMHCA President